Anti-EGFR treatment in patients with Colorectal Cancer

The survival of patients with colorectal cancer (CRC) has increased constantly for many years due to superior surgical techniques, improved postoperative care, regular follow-up and an increased use of effective systemic therapy in the adjuvant and the palliative setting [1,2]. All of these advancements are important, but the establishment of multidisciplinary teams which facilitate optimal selection of therapy for individual patients may have been the most important concept on its own. In recent years a number of biologically active substances attacking specific signalling pathways in cancer cells (targeted therapy) have been developed and included in the treatment of patients with CRC. Three monoclonal antibodies (cetuximab, panitumumab, bevacizumab) have by now been approved for therapy in metastatic CRC (mCRC) [2,3]. Angiogenesis is necessary in tumour development and controlled in part by the vascular endothelial growth system which is inhibited by bevacizumab (Avastin ®) and many other anti-angiogenic drugs. Cetuximab (Erbitux®) and panitumumab (Vectibix®) block the extracellular portion of the epidermal growth factor receptor (EGFR) and these two drugs will be discussed in detail in this chapter.